This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.

Monday, November 03, 2014

Weekly Australian Health IT Links – 03rd November, 2014.

Here are a few I have come across the last week or so.

Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

What a huge week! We have the PCEHR with holes and gathering stuff, we have software that might kill and the NEHTA Chair telling is that NEHTA has been a fantastic success with all it has been asked to do!

Nothing more to say - just get clicking on those links and don’t be too worried if we are seen to be ‘Summoning Deamons’!

brisbanetimes.com.au senior reporter

A new software program installed to manage medication doses at nine Queensland hospitals is likely to kill a patient within the next month, a Queensland Health risk report says.

Last Friday's report on the Metavision Intensive Care program advised the state government that the likelihood of the program causing preventable loss of life "is assessed as likely and expected to occur within the next month".

Health Minister Lawrence Springborg confirmed the report, which described the likelihood of a patient death at 60-90 per cent, to Fairfax Media on Sunday.

Concerns over the software were identified in the past month by the directors of the Intensive Care Units at the Princess Alexandra, Royal Children's and Royal Brisbane and Women's Hospital.

A software glitch that hit the system used to dispense medications to hospital patients in Brisbane’s public Metro North Hospital and Health Service has again put Queensland Health’s technology performance in casualty after the state’s Nurse’ union and Labor Opposition hit out at life threatening dangers revealed in an internal risk report.

The computer bugs affected software supplied by iMDsoft for Metro North’s Metavision Intensive Care system and came to light after risk assessment provided to the state government warned there was a 60 per cent to 90 per cent chance of preventable death occurring over the period of a month if left unaddressed.

The serious near miss and subsequent manual intervention has put health services across Australia on alert over how potential problems and associated risks of eHealth systems are managed as most states pursue the big technology rollouts.

Summary: Queensland's health minister Lawrence Springborg has said that he is not aware of any deaths linked to buggy health software that had been identified as potentially deadly to patients.

By AAP | October 26, 2014 -- 23:24 GMT (10:24 AEST)

Queensland Minister for Health Lawrence Springborg has claimed that he is not aware of any deaths linked to the defective software that manages medication for some of the state's sickest patients.

Queensland Health has reverted to manual systems to check that the correct medication is being doled out to intensive care and other patients after doctors realised that there was a major problem.

A risk report, produced for the government last week, found that there was a 60 to 90 percent likelihood of a patient death within the next month, due to problems with the software, Metavision Intensive Care.

Users accidentally link to someone else's health record.

The Department of Health has been forced to own up to two inadvertent breaches of the national health records system in the past 12 months, the Information Commissioner has revealed.

Legislation underpinning the Personally Controlled Electronic Health Record (PCEHR) demands that the department notifies the Office of the Information Commissioner of any privacy slip-ups that could impact on the integrity of personal medical data stored in the PCEHR system.

In December last year, the department acknowledged to the OAIC that a technical change had introduced a glitch into the system potentially allowing a handful of healthcare providers to access PCEHR user’s personal health notes without authorisation, for a short window of time.

The first was notified in December 2013 and “involved a technical change made to the system that meant that healthcare providers could view consumers’ personal health notes.”

“Investigations by the System Operator identified the cause and a technical fix was put in place to prevent further access,” the report continues, and this response was deemed “appropriate and … no further action was required.”

NICK WINGFIELD

Microsoft has a place on desks, in living rooms and pockets. Now, like many other big technology companies, it believes it belongs on your wrist too.

The company has created a wrist-worn fitness device, Microsoft Band, and a related online service, Microsoft Health, that will analyse the data from the band and other devices to help people with their fitness goals.

And it's making it available across competitor's operating systems, Apple's iOS and Google's Android.

There is "no evidence" patients will be harmed by reading pathology results on their PCEHR before speaking with their GP, a leading Australian e-health expert says.

This month, Australian Doctorrevealed the plan to automatically upload pathology and diagnostic imaging results to the PCEHR after seven days — irrespective of whether the patient had been seen by their GP.

The upgrade is being sold as a major step forward in the clinical relevance of the moribund system.

Federal health bureaucrats say calls to allow doctors to curate pathology and radiology reports before they’re uploaded onto the PCEHR could see some patients never getting their results.

From next year, pathology results and diagnostic imaging will be automatically uploaded to the e-health system seven days after the results have been sent to the ordering doctor. The delay is meant to give GPs time to contact patients and discuss the results.

It’s 10 days or so until the Australian FHIR Connectathon, which is Friday. This post is to help people who are preparing for that connectathon. There’s 3 tracks at the Australian Connectathon:

Track 1: Patient resource (Introductory)

This track serves as the simple introductory task for anyone who hasn’t been to a connectathon before, though previous attendees will find it useful for extending their experience and knowledge. The patient scenario is to write a client that can follow this simple sequence.

I really wonder sometimes. A few months ago, an international organisation that has been looking at how to solve the requirement for scalable, sustainable content modelling (research data sets) did some trialling on the use of archetypes. This worked fine as far as it went. I subsequently received an email to do with what they would do, that contained the line

“There has also been talk in our senior management about using SNOMED for this type of requirement”.

More recently, a colleague from Norway posted on the openEHR list various quotes from a Gartner report that was commissioned by the Norwegian government. The one most relevant here is (this comes from a Norwegian report)

A teen with type 1 diabetes goes on holiday with a friend’s family, her doctor confident her remotely managed and monitored insulin pump will switch on and off as needed.

The scenario is similar for a child with severe asthma, a remote monitoring system prompting SMSed instructions for a dosage change.

This is Dr Stephen Oesterie’s vision of healthcare in five or ten years. “Instead of the patient coming to the doctor, we will allow them to stay in their own environment and distribute healthcare to them through the cloud.”

This means patients with chronic conditions might be fitted with miniature implanted sensors and medication pumps linked to supercomputers around the world through the existing mobile phone network.

Millions allocated in 2012 finally make it to hospitals.

One month out from a state election, the Victorian government has finally emptied the $100 million eHealth piggy bank it set up in 2012, and distributed the funds to hospitals and health services.

Health Minister David Davis this morning announced the winners of the first lot of funds from the $100 million pool, announcing $80 million worth of grants would be drawn from the state’s Innovation, eHealth and Communications Technology Fund.

Davis denied to iTnews that his government had been sitting on the funds in the lead up to a hard-fought election campaign.

Advances in information and communication technologies bring changes to healthcare delivery for providers and consumers.

On average, only between 14 and 43 per cent of patients complete a cardiac rehabilitation program at hospitals or outpatient clinics after suffering a heart attack. One of the reasons for the dropout rate of patients from these rehabilitation programs is difficult access for those living in regional and rural Australia.

Today, technology is offering a potential lifeline to heart attack victims by increasing the accessibility and compliance rates of rehabilitation treatments.

The Australian e-Health Research Centre (AEHRC) has developed the Care Assessment Platform – a solution that uses smartphones, the Internet, and information and communication technology tools to enable patients to carry out post-heart attack rehabilitation in their own home.

Patients use a smartphone with customised software to measure and record data such as the amount of physical activity they do, their weight and blood pressure, and to record sleep quality, stress, meals and any tobacco and alcohol use. This data is synchronised daily to a web-portal, where it is closely monitored and assessed by healthcare providers.

Jessica Gardner

Video game maker Nintendo has said it will work with Australian medical device success story ResMed, best known for its products that reduce snoring, on a consumer health product that tracks quality of sleep.

Nintendo boss Satoru Iwata told a briefing that the device would be the first offering from the Japanese company's newly created health division. "By using our know-how in gaming... to analyse sleep and fatigue, we can create something fun," Iwata said, according to Reuters.

The device will be called a QOL Sensor - referring to 'quality of life' - and will measure chest movements, breathing and heartbeat via microwave transmissions. The data will then be uploaded to the cloud to analyse the data and produce visual representations of sleep and fatigue.

Advances in technology and connectivity have brought about the possibility of online medical clinics for remote and regional areas of Australia, but some healthcare organisations fear that in-person services may suffer as a result.

Last week Telstra announced it will join forces with a Swiss healthcare provider to offer online clinics for remote and regional areas of Australia as soon as next year.

Telstra group executive of retail Gordon Ballantyne says the rapid growth of health spending in Australia makes it a logical decision for the telecommunications giant.

Telstra’s new health business unit and Sydney University’s The George Institute have announced a partnership to explore eHealth solutions for Australia’s straining healthcare system.

Telstra Health has put $2 million into the partnership in the first two years to explore eHealth technologies and services.

The new Telstra business unit has already announced ReadyCare to provide over-the-phone GP services including diagnosis, prescriptions and specialist referrals.

This has been criticized by the Australian Medical Association (AMA) as a commercial solution dressed up as a health solution. The AMA says people should maintain regular contact with their GP, not just the odd phone call.

The new St Stephen’s Hospital in Hervey Bay, which opened last week, is the nation’s first entirely digital medical facility.

Partly funded by a $47 million federal government grant, the hospital has completely digitised record and patient management in addition to a digital drug dispensing facility and a capacity to monitor patients during surgeries.

UnitingCare Health executive director Richard Royle told the ABC that embracing digital was the way of the future.

“It is seen generally as the way of the future in health care, no doubt about it, not dissimilarly to if you think about banking 15 or 20 years ago and think about banking today and look at how electronic it is now in banking, the same will apply over the next decade or two with health care,” he said.

Steve Hambleton has been in the NEHTA chair since June of this year after a successful stint as AMA president. One of the key lessons he’s learned since taking the job is that Australia needs to have a more unified health system if we’re to meet the health challenges of today and tomorrow.

“It’s like having a unified rail gauge,” he says by way of an analogy he frequently comes back to. “You can’t have a unified system if everyone is implementing their own standards, we can’t have an ehealth system unless we’re able to talk about the same things.”

He says that in the nine years NEHTA has been in existence it has been highly successful at the tasks it has been set. There are secure messaging standards, the adoption of SNOMED and other wins, all of which help push the ehealth and health systems in the right direction, Hambleton says.

The idea of telemedicine – healthcare provided using telecommunications equipment – has a lengthy history. Radio News, an American magazine, devoted its cover to a patient at home consulting a doctor in his surgery via a television link as long ago as 1924. When NASA began monitoring astronauts in space in the 1960s, fantasy became reality. It has been touted as healthcare’s future ever since.

But even smartphones and tablets have failed to usher in the telemedicine revolution: most healthcare still happens face to face. Now, enthusiasts think the wait is nearly over.

At an industry conference in Rome this month, participants discussed the problems that must be solved if telemedicine’s day is to come.

CSIRO, St Vincent's Hospital and Victorian biotech company Anatomics have joined together to carry out world-first surgery to implant a titanium-printed heel bone into a Melbourne man.

Printed using CSIRO's state-of-the-art Arcam 3D printer, the heel bone was implanted into 71-year-old Len Chandler, a builder from Rutherglen Victoria, who was facing amputation of the leg below the knee following a diagnosis of cancer of the calcaneus, or heel bone.

St Vincent's Hospital surgeon Professor Peter Choong was aware of CSIRO's work in titanium 3D after reading about our work producing an orthotic horseshoe in 2013, and contacted CSIRO's John Barnes in early June about his vision for a metallic implant which would support the body’s weight.

Google is working on a cancer-detecting pill in its latest effort to push the boundaries of technology.

Still in the experimental stage, the pill is packed with tiny magnetic particles, which can travel through a patient's bloodstream, search for malignant cells and report their findings to a sensor on a wearable device.

As many as 2,000 of these microscopic "nanoparticles" could fit inside a single red blood cell to provide doctors with better insights about what is happening inside their patients.

Adario Strange

There have already been several dire warnings from Tesla and SpaceX founder Elon Musk in recent months regarding the perils of artificial intelligence, but this week he actually managed to raise the bar in terms of making AI seem scary.

First, according to Musk, AI was as dangerous as nuclear war. Now Musk is likening the possible battle between humans and computers in the future, termed by some as "the singularity," as a struggle for the soul of mankind itself.

How so? By invoking the one thing even those with little interest in technology fear the most: demons!